Loading...
HomeMy WebLinkAbout05080252-Applicationr MulU'Family, & Two Family: New Structures, AddiUons, Remodels, & AcceSSOry ~ctures BUILDER'S ENA[L ADDRESS PHONE 7~a. - q~,~, '~ CITY STATE FAX ZIp PROPERTY ~Ar~ ~ -- ~~--~ C¢~ '" I'2 ~'~ F*x OWNER: '~ ~'~' ~' ~[4~ ~'r'. - y - --- _ - ~ STREET ADDRESS CITY ErAql~ aLO~ONpRO3E~ ~BDmS~ON ~E ~ , W ~ S~ON TNF~: ~ ~ ~N~U~ON ~ ~ OF ~N~U~O~ ~ ~ ~ ~VA~ON ~; ~ C~H[SS[~ / ~ / ~ ~ NUN.S; TAC DA~S); ~D/OR ~U~ W2~ AND/OR ~C ~ ~'S (IF AP~: SINGLE FAH[LY TOWN HOME TWO FAMILY // # of units:__________/' MULTi-FAMILY # o~ Un,s:. : I: ' ~; VEM : C~ NEW STRUCTURE [] ROOM ADDTI~ON(S) - i MBZNG CONTRA: OR: Plumber's Zndiana: Early Release Permit: Trusses: Y Y Construction Code) WALKOUT: ~.~mit ts veJid o~ly ff conscmction commences within 18 months of the permits e~e subject m ~c ~ A~a~ve R~ of thc S~tc of India (S~ 675 IAC 12) ~g c~adon ~e fr~ for ~g ~d ~mple~g cons~c~on, com~cdon, ~com~cdo~ ~t, ~a~on, or ~on of a s~c~e, or ~y ~ge ~ ~e u~ of ~d or s~r~ r~u~ted by ~ app~cadon ~ comply ~, ~d co~o~ to, ~ app~cable hws of ~c State of ~a, ~d ~e 'Zomg ~cc of C~d ~ - 1993~ (Z-289) ~d ~ts, adopted und~ au~od~ of LC. 36-7 et s~, G~ ~bly of ~e State of h~ ~d ~ Acts am~to~ · ~to. I ~ c~ ~at oily M~, ba~, ~d fl~r &~s ~e ~t~ to ~e s~t~ sew~. I ~r~ c~ ~t ~e cons~caon ~ not ~ u~cupi~ ~C~catc of~cu~c~ ~ ~u~ by ~e D~m~t of ~u~ty Se~cm, ~. inca. Signature of Owner or Authorized Agent OFF~CE USE ONLY: **********~ Upper Footing Lower Footing Meter Ba Reviewed/Approved: Depb of Community Services (Date) Print Date Filing Fees: ~,)'~ Base inspections: # Chargea Re- ~ Reviews Cert, of Occupancy: __~ OO c*P.R.I.F,: .. Aedmo~l Fees OTA~L: